The visceral adiposity index and risk of type 2 diabetes mellitus in China: A national cohort analysis

Aims Visceral Adiposity Index (VAI) is a sex‐specific index of visceral adiposity based on body mass index, waist circumference, triglycerides and high‐density lipoprotein cholesterol. This study aims to demonstrate the association of VAI and its longitudinal transition patterns with type 2 diabetes mellitus (T2DM) in middle‐aged and older Chinese. Materials and methods Data from the China Health and Retirement Longitudinal Study (2011, 2013, 2015, and 2018) were analysed. Participants were classified into high‐ and low‐VAI groups at baseline, and subsequently into four transition patterns during follow‐up (2011–2015): maintained‐high, maintained‐low, high‐to‐low, and low‐to‐high VAI. Multivariable Cox frailty models with random effects were used to assess the associations of VAI and its transitions with T2DM. Results A total of 7245 participants were analysed, among which 818 developed T2DM by 2018. A positive association between baseline high‐VAI levels and T2DM was observed (HR = 1.49, 95% CI: 1.27–1.75). Compared with people with maintained low‐VAI pattern during follow‐up, those with transition patterns of maintained‐high VAI, high‐to‐low VAI, and low‐to‐high VAI were at higher risk of T2DM (HR = 1.97, 1.52, and 1.56, respectively, all p